Vulnerabilidade às Doenças Sexualmente Transmissíveis em mulheres que comercializam sexo em rota de prostituição e turismo sexual na Região Central do Brasil

OBJETIVO: investigar el conocimiento, conductas de riesgo y signos/síntomas de enfermedades de transmisión sexual de mujeres profesionales del sexo. MÉTODO: estudio transversal con una muestra probabilística compuesta por 395 mujeres reclutadas mediante el método Respondent Driven Sampling entre el 2009 y 2010. Los datos fueron recolectados en entrevistas personales. RESULTADOS: la mayoría de las participantes eran jóvenes adultas, con bajo nivel de educación y poco conocimiento acerca de las formas de transmisión del virus de la inmunodeficiencia humana (VIH). Más de un tercio de las participantes no pudo identificar cuáles son los signos/síntomas de las enfermedades de trasmisión sexual. La prevalencia de flujo vaginal y heridas/úlceras genitales fue del 49,0% y 8,6%, respectivamente, siendo que un 47,7% no solicitó tratamiento. CONCLUSIÓN: los resultados indican la necesidad de políticas públicas de salud dirigidas al control y prevención de enfermedades de trasmisión sexual en la población de profesionales del sexo, especialmente en el caso de las mujeres que actúan en una importante ruta de prostitución y turismo sexual en el centro de Brasil.OBJETIVO: investigar o conhecimento, comportamentos de risco e sinais/sintomas de doenças sexualmente transmissíveis de mulheres profissionais do sexo. MÉTODO: estudo de coorte transversal, de uma amostra probabilística de 395 mulheres, recrutadas pelo método Respondent Driven Sampling, de 2009 a 2010. Os dados foram obtidos por meio de entrevista face a face. RESULTADOS: a maioria era de mulheres adultas jovens, com baixa escolaridade e conhecimento insuficiente sobre formas de transmissão do vírus da imunodeficiência humana. Mais de um terço das mulheres não soube informar os sinais/sintomas das doenças sexualmente transmissíveis. A prevalência de corrimento vaginal e ferida/úlcera foi de 49,0 e 8,6%, respectivamente, sendo que 41,7% dessas não procuraram tratamento. CONCLUSÃO: os resultados evidenciam a necessidade de políticas públicas de saúde voltadas para o controle e prevenção das doenças sexualmente transmissíveis nessa população, especialmente, em mulheres que comercializam sexo em importante rota de prostituição e turismo sexual do Brasil Central.OBJECTIVE: to investigate knowledge on sexually transmitted diseases (STDs), STD-related risk behaviors, and signs/symptoms of STDs among female sex workers (FSWs). METHODS: a cross-sectional study was conducted with a probabilistic sample comprising 395 women recruited using a respondent-driven sampling method between 2009 and 2010. The data were collected during face-to-face interviews. RESULTS: most of the participants were young adults, had a low educational level, and had poor knowledge on the transmission paths of the human immunodeficiency virus (HIV). Over one-third of the participants were not able to describe the signs/symptoms of STDs. The prevalence rates of vaginal discharge and wounds/ulcers were 49.0% and 8.6%, respectively, but 41.7% of the women had not sought treatment. CONCLUSION: the results indicate the need for public health policies focusing on the control and prevention of STDs in this population, especially for the FSWs who are active in an important prostitution and sex tourism route in central Brazil

Epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, Brazil

Knowledge about epidemiological distribution patterns of HIV infection in different geographic regions is relevant to understand the dynamics of the disease in Brazil. This study aims to characterize the epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, from 2005 to 2015. A standardized questionnaire was used to collect clinical-epidemiological, virological, and immunological data from the medical records of all HIV-infected patients (n=539) who were followed at the regional reference center of Jatai, Goias State, Brazil, from 2005 to 2015. We detected the prevalence of male patients and the heterosexual route of transmission, as well as an expressive number of young women infected with HIV. The HIV infection was more prevalent in reproductive ages (55.3%). Most patients presented clinical manifestations related to HIV infection at the time of diagnosis. Twenty-four patients presented coinfection with hepatitis C virus, syphilis, hepatitis B virus, leprosy or Chagas disease. Pneumonia caused by Pneumocystis jirovecii was the most common opportunistic infection, followed by neurotoxoplasmosis, tuberculosis, and neurocryptococcosis. Combined antiretroviral therapy improved CD4+ T-cell counts: the mean CD4+ T-cell counts after treatment was twice as high as those found at the first medical appointment; and highly active antiretroviral therapy promoted viral suppression in a significant number of patients. Considering the increasing distribution of HIV infection to the interior of Brazil, this descriptive study outlines the clinical-epidemiological characteristics of HIV infection in Southwestern Goias and contributes to develop local prevention strategies and public service plans

Hepatitis B vaccination in women sex workers: a challenge for health professionals

Submitted by Erika Demachki ([email protected]) on 2014-12-05T16:45:51Z No. of bitstreams: 2 Dissertação - Luciene Craneiro Moraes - 2011.pdf: 12334490 bytes, checksum: 855890090cc6d406390d24c961299cc6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Erika Demachki ([email protected]) on 2014-12-05T16:46:29Z (GMT) No. of bitstreams: 2 Dissertação - Luciene Craneiro Moraes - 2011.pdf: 12334490 bytes, checksum: 855890090cc6d406390d24c961299cc6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-12-05T16:46:30Z (GMT). No. of bitstreams: 2 Dissertação - Luciene Craneiro Moraes - 2011.pdf: 12334490 bytes, checksum: 855890090cc6d406390d24c961299cc6 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2011-11-27Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEGHepatitis B virus (HBV) infection is geographically distributed in the world and considered and of the most important public health risk. Female sex workers (FSW) are at high risk for HBV infection, and vaccination is the most effective strategy to prevent it. In Brazil, this vaccine is offered to all individuals under 25 years old and groups at high risk for hepatitis B, such as sex workers. This investigation aimed to evaluate the status of immunization, analyze predictor factors, compliance with and response to hepatitis B vaccine using two schemes: standard - G1 (0, 1, 6 months) and accelerated - G2 (0, 1 and 4 months). A total of 319 women was investigated and offered the hepatitis B vaccine. We identified 187 (58.6%) FSWs susceptible for hepatitis B, 170 of them received the first vaccine dose, and 84 were randomized to receive the G1 scheme, and 86 the G2 one. The second dose was administered according the proposed schemes in only 17 and 28 women in G1 and G2, respectively. Fifty-two women were rescued and received the second dose of the vaccine, regardless of the dosing interval, this group was designated GR. The third dose was administered in 6, 11 and 51 women of G1, G2 and GR, respectively. In only 60 women, blood samples were collected for detection of anti-HBs. Seven of them (11.7%) did not develop protective titers of anti HBs, being one of G1 group, one of G2 group and five of GR group. The overall geometric mean titers of anti-HBs were 256.4 mIU / mL: 301.6 mIU/mL in G1, 78.2 mIU/mL in G2 and 339.2 mIU/mL in recovered group. The low frequency of FSWs immunized and the low adherence to hepatitis B vaccination highlight the need of public strategies to reach this population a risk for hepatitis B. On the other hand, the good immunogenicity of the Brazilian hepatitis B vaccine, regardless of dosing intervals, suggests that health professionals should not limit the stiffness of the vaccination scheme and lose the opportunity to immunize this population hard to reach.A infecção pelo vírus da Hepatite B (HBV) é geograficamente distribuída em todo mundo e considerada um importante problema de saúde pública. Mulheres profissionais do sexo (MPS) apresentam um risco elevado para infecção pelo HBV, sendo a vacinação a maneira mais eficaz para sua prevenção. No Brasil, essa vacina é oferecida a todos os indivíduos menores de 25 anos e a grupos que apresentam potencial de risco para hepatite B, como profissionais do sexo. O objetivo deste estudo foi investigar a situação de imunização e analisar fatores preditores de vacinação, como também administrar a vacina contra hepatite B, utilizando dois esquemas: padrão – G1 (0, 1 e 6 meses) e acelerado – G2 (0, 1 e 4 meses), comparando a adesão e a resposta vacinal. Um total de 319 mulheres foi recrutada para o estudo. Destas, 52 (16,3%) já haviam sido expostas ao HBV, 80 (25,1%) apresentavam evidências sorológicas de vacinação prévia, e 187 (58,6%) eram suscetíveis a hepatite B. Ter idade inferior a 30 anos e se prostituir em boates foram preditores de vacinação contra hepatite B (p < 0,05). Do total de mulheres suscetíveis, 170 (91%) concordaram em receber a primeira dose da vacina contra hepatite B, sendo que 84 foram randomizadas para receberem o esquema G1 e 86 o esquema G2. Inicialmente, a segunda dose foi administrada em apenas 17 e 28 mulheres do G1 e G2, respectivamente. Contudo, 52 mulheres foram resgatadas ao longo do estudo e receberam a segunda dose da vacina, independente do intervalo entre doses. Esse grupo foi denominado GR. A terceira dose foi administrada em 6, 11 e 51 mulheres do G1, G2 e GR, respectivamente. Somente em 60 mulheres foi possível a coleta de sangue para detecção do anti-HBs. Destas, sete (11,7%) não desenvolveram títulos protetores de anti-HBs, sendo uma do G1, uma do G2 e cinco do GR. A média geométrica global dos títulos de anti-HBs foi 256,4 mUI/mL: 301,6 mUI/mL no G1, 78,2 mUI/L no G2 e 339,2 mUI/L no GR. A baixa freqüência de MPS imunizadas e de adesão à vacinação contra hepatite B evidenciam a necessidade de estratégias públicas que alcancem esta população em risco para hepatite B. Por outro lado, a boa imunogenicidade da vacina brasileira contra hepatite B, mesmo quando administrada em intervalos irregulares, sugere que para esta população o profissional de saúde não deve se limitar a rigidez dos esquemas de vacinação e perder a oportunidade de imunizar essa população de difícil acesso

Vulnerability to sexually transmitted infections in women who sell sex on the route of prostitution and sex tourism in Central Brazil

Submitted by Franciele Moreira ([email protected]) on 2019-09-19T15:26:25Z No. of bitstreams: 2 Artigo - Marcos André de Matos - 2013.pdf: 364858 bytes, checksum: 5260ab99b39538200797d6f48e528c0e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira ([email protected]) on 2019-09-19T15:33:26Z (GMT) No. of bitstreams: 2 Artigo - Marcos André de Matos - 2013.pdf: 364858 bytes, checksum: 5260ab99b39538200797d6f48e528c0e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2019-09-19T15:33:26Z (GMT). No. of bitstreams: 2 Artigo - Marcos André de Matos - 2013.pdf: 364858 bytes, checksum: 5260ab99b39538200797d6f48e528c0e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2013-08Objective: to investigate knowledge on sexually transmitted diseases (STDs), STD-related risk behaviors, and signs/symptoms of STDs among female sex workers (FSWs). Methods: a cross-sectional study was conducted with a probabilistic sample comprising 395 women recruited using a respondent-driven sampling method between 2009 and 2010. The data were collected during face-to-face interviews. Results: most of the participants were young adults, had a low educational level, and had poor knowledge on the transmission paths of the human immunodeficiency virus (HIV). Over one-third of the participants were not able to describe the signs/symptoms of STDs. The prevalence rates of vaginal discharge and wounds/ulcers were 49.0% and 8.6%, respectively, but 41.7% of the women had not sought treatment. Conclusion: the results indicate the need for public health policies focusing on the control and prevention of STDs in this population, especially for the FSWs who are active in an important prostitution and sex tourism route in central Brazil

Epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, Brazil

ABSTRACT Knowledge about epidemiological distribution patterns of HIV infection in different geographic regions is relevant to understand the dynamics of the disease in Brazil. This study aims to characterize the epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, from 2005 to 2015. A standardized questionnaire was used to collect clinical-epidemiological, virological, and immunological data from the medical records of all HIV-infected patients (n=539) who were followed at the regional reference center of Jatai, Goias State, Brazil, from 2005 to 2015. We detected the prevalence of male patients and the heterosexual route of transmission, as well as an expressive number of young women infected with HIV. The HIV infection was more prevalent in reproductive ages (55.3%). Most patients presented clinical manifestations related to HIV infection at the time of diagnosis. Twenty-four patients presented coinfection with hepatitis C virus, syphilis, hepatitis B virus, leprosy or Chagas disease. Pneumonia caused by Pneumocystis jirovecii was the most common opportunistic infection, followed by neurotoxoplasmosis, tuberculosis, and neurocryptococcosis. Combined antiretroviral therapy improved CD4+ T-cell counts: the mean CD4+ T-cell counts after treatment was twice as high as those found at the first medical appointment; and highly active antiretroviral therapy promoted viral suppression in a significant number of patients. Considering the increasing distribution of HIV infection to the interior of Brazil, this descriptive study outlines the clinical-epidemiological characteristics of HIV infection in Southwestern Goias and contributes to develop local prevention strategies and public service plans